The Second Stage of Labor Questionnaire (SOL-Q): Development and Psychometric Testing

The second stage of labor is an intensive phase of childbirth, culminating in the birth of the baby. Women's experiences during this stage can have significant short- and long-term effects on physical and psychological well-being. Despite this, no validated questionnaires exist to comprehensively assess women's experiences during the second stage of labor.

To evaluate a questionnaire measuring different dimensions of women's experience during the second stage of labor in women giving birth for the first time vaginally.

A study-specific questionnaire was developed to assess experiences of the second stage of labor within a multicenter randomized controlled trial (Oneplus), which aimed to evaluate the assistance of two midwives to reduce severe perineal trauma. The questionnaire was sent 1 month after birth to 2831 women, of which 2221 (78.1%) responded within 3 months. Exploratory factor analysis using principal component analysis and direct Oblimin rotation was performed to identify dimensions of the experience. Known-groups validity was assessed by comparing scores between subgroups expected to differ in childbirth experiences.

Factor analysis of 16 items yielded a four-factor solution that explained 60% of the variance with sufficient reliability coefficients (0.68-0.81). The dimensions were labeled Coping and empowerment, Decision making, Pain perception, and Safety and vulnerability. The questionnaire showed good sensitivity, with dimensions discriminating well between groups hypothesized to differ in experience of childbirth. Women with fear of childbirth, oxytocin augmentation, and those who had a second stage duration over 3 h scored significantly lower in all domains, whereas there were no differences in any of the domains between women assisted by one or by two midwives during the second stage.

The SOL-Q measures important dimensions of women's experience of the second stage when giving birth for the first time vaginally and may be used to assess various dimensions of maternal satisfaction during this stage.